Partial Mastoid Obliteration Combined With Soft-wall Reconstruction for Middle Ear Cholesteatoma

Suzuki, Hideaki; Ikezaki, Shoji; Imazato, Kei; Koizumi, Hiroki; Ohbuchi, Toyoaki; Hohchi, Nobusuke; Hashida, Koichi

doi:10.1177/0003489414525335

Cited by 15 publications

(10 citation statements)

References 26 publications

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“…(Edfeldt et al 2012, 2013, Gaillardin et al 2012, Møller et al 2020, van der Toom et al 2020. Hearing results were also in line with findings from other authors (Yung et al 2007, Suzuki et al 2014.…”

Section: Surgical and Hearing Outcomessupporting

confidence: 91%

Middle ear cholesteatoma : Surgical outcome and aspects of the innate immunity

Westerberg

2020

Linköping University Medical Dissertations

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Cholesteatomas are bone destructive expansions of keratinizing squamous epithelium in the middle ear and temporal bone. Today, surgery is the only treatment. There are several controversies regarding cholesteatomas, including the definition, the pathogenesis and the surgical method. Intense efforts have been made searching for a comprehension of the cholesteatoma process at a cellular and molecular level. Recurrent infections and inflammation seem to be contributing factors for the cholesteatomas to expand. The innate immunity, essential to keep a healthy middle ear environment and to protect the middle ear from intruding pathogens, is therefore a matter of interest. In this thesis, results are presented from a cohort of cholesteatoma surgeries in Östergötland from a 16-year period. A group of patients also filled in a questionnaire to assess changes in health-related quality of life (HRQoL) after surgery. According to the findings in this thesis, the residual and recurrence frequencies are low, and the hearing and HRQoL are improved in the majority of cases. This thesis also presents an investigation of the innate immunity in ears with acquired cholesteatoma, in comparison to controls with healthy middle ears. The expression of mRNA of toll like receptors 2 and 4, participants of the Janus kinase/signal transducer and activator of transcription pathway, and nitric oxide synthases in middle ear mucosa, were investigated with quantitative polymerase chain reaction. An investigation of nitric oxide (NO) in the middle ear, with chemiluminescence measurements, is also presented. A derangement of the innate immune system is seen in ears with cholesteatoma, which supports the idea that the innate immunity participates in the cholesteatoma process, though the underlying mechanisms are still unclear. The suggestion of NO production in the middle ear sheds light on NOs possible participation in the healthy middle ear environment.

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Section: Surgical and Hearing Outcomessupporting

confidence: 91%

Middle ear cholesteatoma : Surgical outcome and aspects of the innate immunity

Westerberg

2020

Linköping University Medical Dissertations

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“…A large number of researches have reported that if cholesteatomatous otitis media is not treated on time, the cholesteatoma will continue to increase, compress sclerotins and be absorbed, and the auditory ossicle will be injured. If bacteria enter into cranium, serious intracranial complications will occur, which may even lead to the patients death (17–19). There are no obvious specific symptoms in the early stage of cholesteatomatous otitis media, and its symptoms are easily confused with the clinical symptoms of patients with simple otitis media.…”

Section: Discussionmentioning

confidence: 99%

Effect of CT manifestations of cholesteatoma on MMP‑2, MMP‑9 and IL‑6 in the serum of patients

Wu¹,

Tang²,

Shao³

et al. 2019

Exp Ther Med

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Effect of CT manifestations of cholesteatomatous otitis media on matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) in the serum of patients was investigated. A total of 176 patients with cholesteatomatous otitis media were enrolled as the study group and 181 patients with simple otitis media were enrolled as the control group. Patients were admitted to the Changxing People's Hospital from January 2010 to December 2016. The patients in the study group were classified according to the 64-row spiral CT diagnosis. The expression levels of MMP-2, MMP-9 and IL-6 in the serum of the selected patients were detected by ELISA. MMP-2, MMP-9 and IL-6 expression levels in the study group were higher than those in the control group (P<0.05). MMP-2, MMP-9 and IL-6 expression levels in the serum of the patients with injured ossicular chain were significantly higher than those in the serum of patients with injured malleus or incus (P<0.05), and significantly higher than those in the serum of patients with intact ossicular chain (P<0.05). The levels of MMP-2, MMP-9 and IL-6 in the serum of the patients whose malleus or incus was injured were higher than those in the serum of the patients with intact ossicular chain (P<0.05). There was an obvious positive correlation between the injury degree of different sclerotins in CT manifestations of the patients in the study group and MMP-2, MMP-9, and IL-6 (P<0.05). The high expression levels of MMP-2, MMP-9 and IL-6 in the serum of patients with cholesteatomatous otitis media were positively correlated with the injury degree of ossicle, which may be a sign of poor prognosis of cholesteatomatous otitis media.

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“…Concerning the classical CWD procedure with an open mastoid cavity, the emphasis of most studies has been on the management of postoperative chronic otorrhea [2,13,20,21,26]. Several partial or complete obliteration techniques with excellent anatomical results have been published [27,28,29,30]. …”

Section: Discussionmentioning

confidence: 99%

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

Minovi¹,

Dombrowski²,

Shahpasand³

et al. 2015

ORL

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In this retrospective study, we evaluated the audiometric results after using the retrograde mastoidectomy technique with open mastoid cavity for the removal of extended attic cholesteatomas. The described technique was used for cholesteatoma removal in 168 adult patients with an average follow-up time of 12 months. Due to cholesteatoma extension far into the mastoid, the disease was eradicated by the canal wall down (CWD) technique with the creation of an open mastoid cavity. Primary surgery was carried out in 47% of ears, with the remaining 53% representing revision surgery. In all cases, a classical CWD with an open mastoid cavity and partial obliteration with cartilage was created. A dry ear was achieved in 94% of cases. A postoperative air-bone gap ≤20 dB was achieved in 42.9% of the operated ears. 9.3% (n = 15) of the operated ears showed a postoperative air-bone gap >30 dB. Important factors leading to significantly better hearing restoration were an intact malleus, the use of alloplastic titanium prostheses and primary surgery. Although most cholesteatomas nowadays can be eradicated with the canal wall up technique, in far advanced cholesteatomas, the CWD technique can be applied with acceptable postoperative hearing results.

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Partial Mastoid Obliteration Combined With Soft-wall Reconstruction for Middle Ear Cholesteatoma

Abstract: The surgical outcomes of tympanoplasty with partial mastoid obliteration and soft-wall reconstruction for middle ear cholesteatoma were satisfactory with a low incidence of cholesteatoma recidivism and tolerable postoperative hearing without cavity problems.

Cited by 15 publications

References 26 publications

Middle ear cholesteatoma : Surgical outcome and aspects of the innate immunity

Middle ear cholesteatoma : Surgical outcome and aspects of the innate immunity

Effect of CT manifestations of cholesteatoma on MMP‑2, MMP‑9 and IL‑6 in the serum of patients

Audiometric Results of Open Cavity Tympanomastoidectomy in Advanced Attic Cholesteatoma

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